Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector83910.54101/ACEN.2023.2.7ReviewsОбзорыReview ArticleCOVID-19 Features in Patients with Multiple Sclerosis: Main Approaches to Their Management, Treatment, and VaccinationОсобенности COVID-19 у пациентов с рассеянным склерозом: основные подходы к ведению пациентов, лечению и вакцинацииhttps://orcid.org/0000-0003-2230-3750MalkoValeriya A.МалькоВалерия Алексеевна
Russian Federation

postgraduate student, Department of neurology and psychiatry with the clinic, Medical Education Institute

аспирант каф. неврологии и психиатрии с клиникой ИМО

malko_VA@almazovcentre.ruhttps://orcid.org/0000-0002-1848-8775BisagaGennady N.БисагаГеннадий Николаевич
Russian Federation

D. Sci. (Med.), Professor, Department of neurology and psychiatry with the clinic, Medical Education Institute

д.м.н., профессор каф. неврологии и психиатрии с клиникой ИМО

bisaga_GN@almazovcentre.ruhttps://orcid.org/0000-0002-0175-3085TopuzovaMariya P.ТопузоваМария Петровна
Russian Federation

Cand. Sci. (Med.), Associate Professor, Department of neurology and psychiatry with the clinic, Medical Education Institute, senior researcher, Research laboratory of new Coronavirus infection and postcovid syndrome of the world-class scientific center "Center for Personalized Medicine"

к.м.н., доцент каф. неврологии и психиатрии с клиникой ИМО, с.н.с. НИЛ новой коронавирусной инфекции и постковидного синдрома НЦМУ «Центр персонализированной медицины»

topuzova_MP@almazovcentre.ruhttps://orcid.org/0000-0002-0074-4021TernovykhIvan K.ТерновыхИван Константинович
Russian Federation

assistant, Department of neurology and psychiatry with the clinic, Medical Education Institute

ассистент каф. неврологии и психиатрии с клиникой ИМО

Ternovykh_IK@almazovcentre.ruhttps://orcid.org/0000-0002-4441-1165AlekseevaTatyana M.АлексееваТатьяна Михайловна
Russian Federation

D. Sci. (Med.), Associate Professor, Department of neurology and psychiatry with the clinic, Medical Education Institute

д.м.н., профессор, зав. каф. неврологии и психиатрии

Alekseeva_TM@almvazovcentre.ruAlmazov National Medical Research CentreФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова»2106202317251600104202220052022Copyright ©; 2023, Malko V.A., Bisaga G.N., Topuzova M.P., Ternovykh I.K., Alekseeva T.M.Copyright ©; 2023, Малько В.А., Бисага Г.Н., Топузова М.П., Терновых И.К., Алексеева Т.М.2023Malko V.A., Bisaga G.N., Topuzova M.P., Ternovykh I.K., Alekseeva T.M.Малько В.А., Бисага Г.Н., Топузова М.П., Терновых И.К., Алексеева Т.М.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/839

The COVID-19 pandemic calls for correct and evidence-based decisions regarding management and treatment of patients with multiple sclerosis. Information on researches, clinical cases, and recommendations for treatment of such patients during the pandemic should be classified. We report COVID-19 features in patients with multiple sclerosis, risk factors for infection and development of severe disease. We also describe management strategies for multiple sclerosis: from relapse treatment to the selection of disease-modifying therapies focusing on patient’s safety. We analyze the latest observational and comparative studies, clinical cases of multiple sclerosis patients vaccination and demyelinating disease onset after COVID-19 or vaccination.

В период пандемии новой коронавирусной инфекции (COVID-19) важно принимать верные и основанные на доказательствах решения о тактике ведения и лечения пациентов с рассеянным склерозом (РС). Необходима систематизация информации об исследованиях и клинических случаях, рекомендациях по лечению пациентов с РС во время пандемии. В статье представлены особенности течения COVID-19 у пациентов с РС, факторы риска заражения и тяжёлого течения инфекции, описаны методы лечения РС — от терапии обострения до терапии препаратами, изменяющими течение РС, в контексте безопасности их применения и тактики ведения пациентов. Проанализированы последние наблюдательные и сравнительные исследования, клинические случаи вакцинации пациентов с РС и дебюты демиелинизирующих заболеваний после COVID-19 и вакцинации.

multiple sclerosisCOVID-19demyelinating diseasesрассеянный склерозновая коронавирусная инфекциядемиелинизирующие заболеванияМинистерство науки и высшего образования Российской ФедерацииMinistry of Science and Higher Education of the Russian Federation075-15-2022-301Colais P., Cascini S., Balducci M. et al. Impact of the COVID-19 pandemic on access to healthcare services amongst patients with multiple sclerosis in the Lazio region, Italy. Eur. J. Neurol. 2021;28(10):3403–3410. doi: 10.1111/ene.14879Safavi F., Nourbakhsh B., Azimi A.R. B-cell depleting therapies may affect susceptibility to acute respiratory illness among patients with multiple sclerosis during the early COVID-19 epidemic in Iran. Mult. Scler. Relat. Disord. 2020;43:102195. doi: 10.1016/j.msard.2020.102195Louapre C., Collongues N., Stankoff B. et al. Clinical characteristics and outcomes in patients with Coronavirus Disease 2019 and multiple sclerosis. JAMA Neurol. 2020;77(9):1079–1088. doi: 10.1001/jamaneurol.2020.2581Chaudhry F., Bulka H., Rathnam A.S. et al. COVID-19 in multiple sclerosis patients and risk factors for severe infection. J. Neurol. Sci. 2020;418:117147. doi: 10.1016/j.jns.2020.117147Zabalza A., Cárdenas-Robledo S., Tagliani P. et al. COVID-19 in multiple sclerosis patients: susceptibility, severity risk factors and serological response. Eur. J. Neurol. 2021;28(10):3384–3395. doi: 10.1111/ene.14690Parrotta E., Kister I., Charvet L. et al. COVID-19 outcomes in MS: observational study of early experience from NYU Multiple Sclerosis Comprehensive Care Center. Neurol. Neuroimmunol. Neuroinflamm. 2020;7(5):e835. doi: 10.1212/NXI.0000000000000835Sormani M.P., Schiavetti I., Carmisciano L. et al. COVID-19 severity in multiple sclerosis: putting data into context. Neurol. Neuroimmunol. Neuroinflamm. 2021;9(1):e1105. doi:10.1212/NXI.0000000000001105Evangelou N., Garjani A., dasNair R. et al. Self-diagnosed COVID-19 in people with multiple sclerosis: a community-based cohort of the UK MS Register. J. Neurol. Neurosurg. Psychiatry. 2020;92(1):107–109. doi: 10.1136/jnnp-2020-324449Salter A., Fox R.J., Newsome S.D. et al. Outcomes and risk factors associated with SARS-CoV-2 infection in a North American registry of patients with multiple sclerosis. JAMA Neurol. 2021;78(6):699–708. doi: 10.1001/jamaneurol.2021.0688REDONE.br — Neuroimmunology Brazilian Study Group Focused on COVID-19 and MS. Incidence and clinical outcome of Coronavirus disease 2019 in a cohort of 11,560 Brazilian patients with multiple sclerosis. Mult. Scler. 2021:1352458520978354. doi: 10.1177/1352458520978354Oran D.P., Topol E.J. The proportion of SARS-CoV-2 infections that are asymptomatic : a systematic review. Ann. Intern. Med. 2021;174(5):655–662. doi: 10.7326/M20-6976Barzegar M., Mirmosayyeb O., Gajarzadeh M. et al. COVID-19 among patients with multiple sclerosis: a systematic review. Neurol. Neuroimmunol. Neuroinflamm. 2021;8(4):e1001. doi: 10.1212/NXI.0000000000001001van Kempen Z.L.E., Strijbis E.M.M., Al M.M.C.T. et al. SARS-CoV-2 antibodies in adult patients with multiple sclerosis in the Amsterdam MS Cohort. JAMA Neurol. 2021;78(7):880–882. doi: 10.1001/jamaneurol.2021.1364Sormani M.P., De Rossi N., Schiavetti I. et al. Disease-modifying therapies and coronavirus disease 2019 severity in multiple sclerosis. Ann. Neurol. 2021;89(4):780–789. doi: 10.1002/ana.26028Sormani M.P., Salvetti M., Labauge P. et al. DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France. Ann. Clin. Transl. Neurol. 2021;8(8):1738–1744. doi: 10.1002/acn3.51408Klineova S., Harel A., Straus Farber R. et al. Outcomes of COVID-19 infection in multiple sclerosis and related conditions: one-year pandemic experience of the multicenter New York COVID-19 Neuroimmunology Consortium (NYCNIC). Mult. Scler. Relat. Disord. 2021;55:103153. doi: 10.1016/j.msard.2021.103153Zaki N., Alashwal H., Ibrahim S. Association of hypertension, diabetes, stroke, cancer, kidney disease, and high-cholesterol with COVID-19 disease severity and fatality: a systematic review. Diabetes Metab. Syndr. 2020;14(5):1133–1142. doi: 10.1016/j.dsx.2020.07.005Reder A.T., Centonze D., Naylor M.L. et al. COVID-19 in patients with multiple sclerosis: associations with disease-modifying therapies. CNS Drugs. 2021;35(3):317–330. doi: 10.1007/s40263-021-00804-1Citterio A., La Mantia L., Ciucci G. et al. Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. Cochrane Database Syst. Rev. 2000;2000(4). doi: 10.1002/14651858.CD001331Топузова М.П., Алексеева Т.М., Чайковская А.Д. и др. Особенности ведения пациентов с неврологическими заболеваниями в период пандемии COVID-19. Артериальная гипертензия. 2020;26(4):447–461. Topuzova M.P., Alekseeva T.M., Chaikovskaya A.D. et al. The management of patients with neurological diseases during the COVID-19 pandemic. Arterial hypertension. 2020;26(4):447–461. (In Russ.) doi: 10.18705/1607-419X-2020-26-4-447-461Kieseier B.C. The mechanism of action of interferon-β in relapsing multiple sclerosis. CNS Drugs. 2011;25(6):491–502. doi: 10.2165/11591110-000000000-00000Jacobs L.D., Cookfair D.L., Rudick R.A. et al. Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG). Ann. Neurol. 1996;39(3):285–294. doi: 10.1002/ana.410390304La Mantia L., Di Pietrantonj C., Rovaris M. et al. Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis. Cochrane Database Syst. Rev. 2016;2016(11):CD009333. doi: 10.1002/14651858.CD009333.pub3Newsome S.D., Kieseier B.C., Arnold D.L. et al. Subgroup and sensitivity analyses of annualized relapse rate over 2 years in the ADVANCE trial of peginterferon beta-1a in patients with relapsing-remitting multiple sclerosis. J. Neurol. 2016;263(9):1778–1787. doi: 10.1007/s00415-016-8182-4Berger J.R., Brandstadter R., Bar-Or A. COVID-19 and MS disease-modifying therapies. Neurol. Neuroimmunol. Neuroinflamm. 2020;7(4):e761. doi: 10.1212/NXI.0000000000000761Hung I.F., Lung K.C., Tso E.Y. et al. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020;395(10238):1695–1704. doi: 10.1016/S0140-6736(20)31042-4Ader F., Discovery French Trial Management Team. Protocol for the DisCoVeRy trial: multicentre, adaptive, randomised trial of the safety and efficacy of treatments for COVID-19 in hospitalised adults. BMJ Open. 2020;10(9):e041437. doi: 10.1136/ bmjopen-2020-041437Hauser S.L., Bar-Or A., Comi G. et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. N. Engl. J. Med. 2017;376(3):221–234. doi: 10.1056/NEJMoa1601277Cross A.H., Naismith R.T. Established and novel disease modifying treatments in multiple sclerosis. J. Intern. Med. 2014;275(4):350–363. doi: 10.1111/joim.12203Comi G., Filippi M., Wolinsky J.S. European/Canadian multicenter, double-blind, randomized, placebo-controlled study of the effects of glatiramer acetate on magnetic resonance imaging — measured disease activity and burden in patients with relapsing multiple sclerosis. European/Canadian Glatiramer Acetate Study Group. Ann. Neurol. 2001;49(3):290–297.Khan O., Rieckmann P., Boyko A. et al. Three times weekly glatiramer acetate in relapsing-remitting multiple sclerosis. Ann. Neurol. 2013;73(6):705–713. doi: 10.1002/ana.23938Giovannoni G., Hawkes C., Lechner-Scott J. et al. The COVID-19 pandemic and the use of MS disease-modifying therapies. Mult. Scler. Relat. Disord. 2020;39:102073. doi: 10.1016/j.msard.2020.102073Fox R.J., Miller D.H., Phillips J.T. et al. Placebo controlled, phase 3 study of oral BG-12 or glatiramer in multiple sclerosis. N. Engl. J. Med. 2012;367:1087–1097. doi: 10.1056/NEJMoa1206328Magne D., Mézin F., Palmer G., Guerne P.A. The active metabolite of leflunomide, A77 1726, increases proliferation of human synovial fibroblasts in presence of IL-1beta and TNF-alpha. Inflamm. Res. 2006;55(11):469–475. doi: 10.1007/s00011-006-5196-xPaolicelli D., Manni A., Iafaldano A., Trojano M. Efcacy and safety of oral therapies for relapsing-remitting multiple sclerosis. CNS Drugs. 2020;34(1):65–92. doi: 10.1007/s40263-019-00691-7Vermersch P., Czlonkowska A., Grimaldi L.M. et al. Teriflunomide versus subcutaneous interferon beta-1a in patients with relapsing multiple sclerosis: a randomised, controlled phase 3 trial. Mult. Scler. J. 2014;20(6):705–716. doi: 10.1177/1352458513507821Gold R., Kappos L., Arnold D.L. et al. Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N. Engl. J. Med. 2012;367(12):1098–1107. doi: 10.1056/NEJMoa1114287Xiong R., Zhang L., Li S. et al. Novel and potent inhibitors targeting DHODH are broad-spectrum antivirals against RNA viruses including newly-emerged coronavirus SARS-CoV-2. Protein Cell. 2020;11(10):723–739. doi: 10.1007/s13238-020-00768-wCabreira V., Abreu P., Soares-Dos-Reis R. et al. Multiple sclerosis, disease-modifying therapies and COVID-19: a systematic review on immune response and vaccination recommendations. Vaccines (Basel). 2021;9(7):773. doi: 10.3390/vaccines9070773Bowen J.D., Brink J., Brown T.R. et al. COVID-19 in MS: initial observations from the Pacific Northwest. Neurol. Neuroimmunol. Neuroinflamm. 2020;7(5):e783. doi: 10.1212/NXI.0000000000000783Ciampi E., Uribe-San-Martin R., Cárcamo C. COVID-19 pandemic: the experience of a multiple sclerosis centre in Chile. Mult. Scler. Relat. Disord. 2020;42:102204. doi: 10.1016/j.msard.2020.102204Maghzi A.H., Houtchens M.K., Preziosa P. et al. COVID-19 in terifluno- mide-treated patients with multiple sclerosis. J. Neurol. 2020;267(10):2790–2796. doi: 10.1007/s00415-020-09944-8Xu Z., Zhang F., Sun F. et al. Dimethyl fumarate for multiple sclerosis. Cochrane Database Syst. Rev. 2015;2015(4). doi: 10.1002/14651858.CD011076.pub2Capone F., Ferraro E., Motolese F., Di Lazzaro V. COVID-19 in multiple sclerosis patients treated with dimethyl fumarate. J. Neurol. 2021; 268(9):3132-3134. doi: 10.1007/s00415-021-10446-4Mantero V., Abate L., Basilico P. et al. COVID-19 in dimethyl fumarate-treated patients with multiple sclerosis. J. Neurol. 2020;268:2023–2025. doi: 10.1007/s00415-020-10015-1Zheng C., Kar I., Chen C.K. et al. Multiple sclerosis disease-modifying therapy and the COVID-19 pandemic: implications on the risk of infection and future vaccination. CNS Drugs. 2020;34(9):879–896. doi: 10.1007/s40263-020-00756-yCalabresi P.A., Radue E.W., Goodin D. et al. Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): A double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2014;13(6):545–556. doi: 10.1016/S1474- 4422(14)70049-3La Mantia L., Tramacere I., Firwana B. et al. Fingolimod for relapsing-remitting multiple sclerosis. Cochrane Database Syst. Rev. 2016;2016(4):CD009371. doi: 10.1002/14651858.CD009371.pub2Хачанова Н.В., Бойко А.Н., Бахтиярова К.З. и др. Рекомендации экспертного совещания «Вторично-прогрессирующий рассеянный склероз: нерешенные вопросы и перспективы». Неврология, нейропсихиатрия, психосоматика. 2019;11(4):172–175. Khachanova N.V., Boyko A.N., Bakhtiyarova K.Z. et al. Recommendations from the Expert Meeting «Secondary progressive multiple sclerosis: unresolved issues and prospects». Neurology, neuropsychiatry, psychosomatics. 2019;11(4):172–175. (In Russ.).Habek M., Jakob Brecl G., Bašić Kes V. et al. Humoral immune response in convalescent COVID-19 people with multiple sclerosis treated with high-efficacy disease-modifying therapies: A multicenter, case-control study. J. Neuroimmunol. 2021;359:577696. doi: 10.1016/j.jneuroim.2021.577696Bsteh G., Dürauer S., Assar H. et al. Humoral immune response after COVID-19 in multiple sclerosis: a nation-wide Austrian study. Mult. Scler. 2021;27(14):2209–2218. doi: 10.1177/13524585211049391Conte W.L. Attenuation of antibody response to SARS-CoV-2 in a patient on ocrelizumab with hypogammaglobulinemia. Mult. Scler. Relat. Disord. 2020;44:102315. doi: 10.1016/j.msard.2020.102315Bollo L., Guerra T., Bavaro D.F. et al. Seroconversion and indolent course of COVID-19 in patients with multiple sclerosis treated with fingolimod and teriflunomide. J. Neurol. Sci. 2020;416:117011. doi: 10.1016/j.jns.2020.117011Foerch C., Friedauer L., Bauer B. et al. Severe COVID-19 infection in a patient with multiple sclerosis treated with fingolimod. Mult. Scler. Relat. Disord. 2020;42:102180. doi: 10.1016/j.msard.2020.102180Valencia-Sanchez C., Wingerchuk D.M. A fine balance: immunosuppression and immunotherapy in a patient with multiple sclerosis and COVID-19. Mult. Scler. Relat. Disord. 2020;42:102182. doi: 10.1016/j.msard.2020.102182Rimmer K., Farber R., Thakur K. et al. Fatal COVID-19 in an MS patient on natalizumab: a case report. Mult. Scler. J. Exp. Transl. Clin. 2020;6(3):2055217320942931. doi: 10.1177/2055217320942931Menge T., Dubey D., Warnke C. et al. Ocrelizumab for the treatment of relapsing-remitting multiple sclerosis. Exp. Rev. Neurother. 2016;16(10):1131–1139. doi: 10.1080/14737175.2016.1227242Montalban X., Hauser S.L., Kappos L. et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N. Engl. J. Med. 2017;376(3):209–220. doi: 10.1056/NEJMoa1606468Coles A.J., Twyman C.L., Arnold D.L. et al. Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial. Lancet. 2012;380(9856):1829–1839. doi: 10.1016/S0140-6736(12)61768-1Rommer P.S., Zettl U.K., Kieseier B. et al. Requirement for safety monitoring for approved multiple sclerosis therapies: an overview. Clin. Exp. Immunol. 2014;175(3):397–407. doi: 10.1111/cei.12206Касаткин Д.С, Cнирин Н.Н., Бойко А.Н., Власов Я.В. Унификация оценки побочных эффектов терапии препаратами, изменяющими течение рассеянного склероза. Журнал неврологии и психиатрии им. C.C. Корсакова. 2014;114(2-2):78–82. Kasatkin D., Spirin N., Boyko A., Vlasov Ya. Unification of the assessment of side effects of therapy with drugs that change the course of multiple sclerosis. Journal of Neurology and Psychiatry named after S.S. Korsakov. 2014;(2):78–82.Sahraian M.A., Azimi A., Navardi S. et al. Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis. Mult. Scler. Relat. Disord. 2020;46:102472. doi: 10.1016/j.msard.2020.102472Попова Е.В. Клинический случай COVID-19 у пациента на терапии препаратом алемтузумаб. Медицинский совет. 2021;(19):148–152. Popova E.V. Clinical case of COVID-19 in a patient treated with alemtuzumab. Medical advice. 2021;19:148–152. doi: 10.21518/2079-701X-2021-19-148-152Iannetta M., Cesta N., Stingone C. et al. Mild clinical manifestations of SARS-CoV-2 related pneumonia in two patients with multiple sclerosis under treatment with ocrelizumab. Mult. Scler. Relat. Disord. 2020;45:102442. doi: 10.1016/j.msard.2020.102442Wurm H., Attfield K., Iversen A.K. et al. Recovery from COVID-19 in a B-cell-depleted multiple sclerosis patient. Mult. Scler. 2020;26(10):1261–1264. doi: 10.1177/1352458520943791Woo M.S., Steins D., Häußler V. et al. Control of SARS-CoV-2 infection in rituximab-treated neuroimmunological patients. J. Neurol. 2021;268(1):5–7. doi: 10.1007/s00415-020-10046-8Maillart E., Papeix C., Lubetzki C. et al. Beyond COVID-19: DO MS/NMO-SD patients treated with anti-CD20 therapies develop SARS-CoV2 antibodies? Mult. Scler. Relat. Disord. 2020;46:102482. doi: 10.1016/j.msard.2020.102482Thornton J.R., Harel A. Negative SARS-CoV-2 antibody testing following COVID-19 infection in two MS patients treated with ocrelizumab. Mult. Scler. Relat. Disord. 2020;44:102341. doi: 10.1016/j.msard.2020.102341Giovannoni G. Cladribine to treat relapsing forms of multiple sclerosis. Neurotherapeutics. 2017;14(4):874–887. doi: 10.1007/s13311-017-0573-4Gelibter S., Orrico M., Filippi M., Moiola L. COVID-19 with no antibody response in a multiple sclerosis patient treated with cladribine: implication for vaccination program? Mult. Scler. Relat. Disord. 2021;49:102775. doi: 10.1016/j.msard.2021.102775De Angelis M., Petracca M., Lanzillo R. et al. Mild or no COVID-19 symptoms in cladribine-treated multiple sclerosis: Two cases and implications for clinical practice. Mult. Scler. Relat. Disord. 2020;45:102452. doi: 10.1016/j.msard.2020.102452Celius E.G. Normal antibody response after COVID-19 during treatment with cladribine. Mult. Scler. Relat. Disord. 2020;46:102476. doi: 10.1016/j.msard.2020.102476Preziosa P., Rocca M.A., Nozzolillo A. et al. COVID-19 in cladribine-treated relapsing-remitting multiple sclerosis patients: a monocentric experience. J. Neurol. 2021;268(8):2697–2699. doi: 10.1007/s00415-020-10309-4Lafarge A., Mabrouki A., Yvin E. et al. Coronavirus disease 2019 in immunocompromised patients: a comprehensive review of coronavirus disease 2019 in hematopoietic stem cell recipients. Curr. Opin. Crit. Care. 2022;28(1):83–89. doi: 10.1097/MCC.0000000000000907Fernández-Ruiz M., Aguado J.M. Severe acute respiratory syndrome coronavirus 2 infection in the stem cell transplant recipient — clinical spectrum and outcome. Curr. Opin. Infect. Dis. 2021;34(6):654–662. doi: 10.1097/QCO.0000000000000790Disanto G., Sacco R., Bernasconi E. et al. Association of disease-modifying treatment and anti-CD20 infusion timing with humoral response to 2 SARS-CoV-2 vaccines in patients with multiple sclerosis. JAMA Neurol. 2021;78(12):1529–1531. doi: 10.1001/jamaneurol.2021.3609Achiron A., Mandel M., Dreyer-Alster S. et al. Humoral immune response in multiple sclerosis patients following PfizerBNT162b2 COVID19 vaccination: up to 6 months cross-sectional study. J. Neuroimmunol. 2021;361:577746. doi: 10.1016/j.jneuroim.2021.577746Buttari F., Bruno A., Dolcetti E. et al. COVID-19 vaccines in multiple sclerosis treated with cladribine or ocrelizumab. Mult. Scler. Relat. Disord. 2021;52:102983. doi: 10.1016/j.msard.2021.102983Khayat-Khoei M., Conway S., Rubinson D.A. et al. Negative anti-SARS-CoV-2 S antibody response following Pfizer SARS-CoV-2 vaccination in a patient on ocrelizumab. J. Neurol. 2021;268(10):3592–3594. doi: 10.1007/s00415-021-10463-3Chilimuri S., Mantri N., Gongati S. et al. COVID-19 vaccine failure in a patient with multiple sclerosis on ocrelizumab. Vaccines (Basel). 2021;9(3):219. doi: 10.3390/vaccines9030219Tillett R.L., Sevinsky J.R., Hartley P.D. et al. Genomic evidence for reinfection with SARS-CoV-2: a case study. Lancet Infect. Dis. 2021;21(1):52–58. doi: 10.1016/S1473-3099(20)30764-7Хачанова НВ, Тотолян НА, Власов ЯВ и др. Рекомендации по вакцинации пациентов с рассеянным склерозом от COVID-19. Неврология, нейропсихиатрия, психосоматика. 2021;13(2):157–161. Khachanova N.V., Totolyan N.A., Vlasov Ya.V. et al. COVID-19 vaccination guidelines for patients with multiple sclerosis. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(2):157–161. DOI: 10.14412/20742711-2021-2-157-161Pignolo A., Aprile M., Gagliardo C. et al. Clinical onset and multiple sclerosis relapse after SARS-CoV-2 infection. Neurol. Int. 2021;13(4):695–700. doi: 10.3390/neurolint13040066Moore L., Ghannam M., Manousakis G. A first presentation of multiple sclerosis with concurrent COVID-19 infection. eNeurologicalSci. 2021;22:100299. doi: 10.1016/j.ensci.2020.100299Palao M., Fernández-Díaz E., Gracia-Gil J. et al. Multiple sclerosis following SARS-CoV-2 infection. Mult. Scler. Relat. Disord. 2020;45:102377. doi: 10.1016/j.msard.2020.102377Yavari F., Raji S., Moradi F., Saeidi M. Demyelinating changes alike to multiple sclerosis: a case report of rare manifestations of COVID-19. Case Rep. Neurol. Med. 2020;2020:6682251. doi: 10.1155/2020/6682251Berrichi S., Bouayed Z., Berrajaa S. et al. Acute disseminated encephalomyelitis: a rare form of COVID-19’s neurotropism. Ann. Med. Surg. (Lond). 2021;71:102940. doi: 10.1016/j.amsu.2021.102940Ozgen Kenangil G., Ari B.C., Guler C., Demir M.K. Acute disseminated encephalomyelitis-like presentation after an inactivated coronavirus vaccine. Acta Neurol. Belg. 2021;121(4):1089–1091. doi: 10.1007/s13760-021-01699-xCao L., Ren L. Acute disseminated encephalomyelitis after severe acute respiratory syndrome coronavirus 2 vaccination: a case report. Acta Neurol. Belg. 2022;122(3):793–795. doi: 10.1007/s13760-021-01608-2Wong P.F., Craik S., Newman P. et al. Lessons of the month 1: a case of rhombencephalitis as a rare complication of acute COVID-19. Clin. Med. 2020;20:293–299. doi: 10.7861/clinmed.2020-0182Utukuri P.S., Bautista A., Lignelli A., Moonis G. Possible acute disseminated encephalomyelitis related to severe acute respiratory syndrome coronavirus 2 infection. Am. J. Neuroradiol. 2020;41:E82–Е83. doi: 10.3174/ajnr.A6714Paterson R.W., Brown R.L., Benjamin L. et al. The emerging spectrum of COVID-19 neurology: сlinical, radiological and laboratory findings. Brain. 2020;143:3104–3120. doi: 10.1093/brain/awaa240Novi G., Rossi T., Pedemonte E. et al. Acute disseminated encephyalomyelitis after SARS-CoV-2 infection. Neurol. Neuroimmunol. Neuroinflamm. 2020;7:e797. doi: 10.1212/NXI.00000 00000000797Otluoglu G.D., Yener U., Demir M.K., Yilmaz B. Encephalomyelitis associated with COVID-19 infection: сase report. Br. J. Neurosurg. 2020:1–3. doi: 10.1080/02688697.2020.1787342McCuddy M., Kelkar P., Zhao Y., Wicklund D. Acute demyelinating encephalomyelitis (ADEM) in COVID-19 infection: a case series. Neurol. India. 2020;68(5):1192–1195. doi: 10.4103/0028-3886.299174de Ruijter N.S., Kramer G., Gons R.A.R., Hengstman G.J.D. Neuromyelitis optica spectrum disorder after presumed COVID-19 infection: a case report. Mult. Scler. Relat. Disord. 2020;46:102474. doi: 10.1016/j.msard.2020.102474Ghosh R., De K., Roy D. et al. A case of area postrema variant of neuromye- litis optica spectrum disorder following SARSCoV-2 infection. J. Neuroimmunol. 2020;350:577439. doi: 10.1016/j.jneuroim.2020.577439Batum M., Kisabay Ak A., Mavioğlu H. COVID-19 infection-induced neuromyelitis optica: a case report. Int. J. Neurosci. 2022;132(10):999–1004. doi: 10.1080/00207454.2020.1860036Toljan K., Amin M., Kunchok A., Ontaneda D. New diagnosis of multiple sclerosis in the setting of mRNA COVID-19 vaccine exposure. J. Neuroimmunol. 2022;362:577785. doi: 10.1016/j.jneuroim.2021.577785Khayat-Khoei M., Bhattacharyya S., Katz J. et al. COVID-19 mRNA vaccination leading to CNS inflammation: a case series. J. Neurol. 2022;269(3):1093–1106. doi: 10.1007/s00415-021-10780-7Havla J., Schultz Y., Zimmermann H. et al. First manifestation of multiple sclerosis after immunization with the Pfizer-BioNTech COVID-19 vaccine. J. Neurol. 2022;269(1):55–58. doi: 10.1007/s00415-021-10648-wFujimori J., Miyazawa K., Nakashima I. Initial clinical manifestation of multiple sclerosis after immunization with the Pfizer-BioNTech COVID-19 vaccine. J. Neuroimmunol. 2021;361:577755. doi: 10.1016/j.jneuroim.2021.577755Voysey M., Clemens S.A.C., Madhi S.A. et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021;397(10269):98–111. doi: 10.1016/S0140-6736(20)32661-1Badrawi N., Kumar N., Albastaki U. Post COVID-19 vaccination neuromyelitis optica spectrum disorder: Case report & MRI findings. Radiol. Case Rep. 2021;16(12):3864–3867. doi: 10.1016/j.radcr.2021.09.033Permezel F., Borojevic B., Lau S., de Boer H.H. Acute disseminated encephalomyelitis (ADEM) following recent Oxford/AstraZeneca COVID-19 vaccination. Forensic Sci. Med. Pathol. 2022;18(1):74–79. doi: 10.1007/s12024-021-00440-7Rinaldi V., Bellucci G., Romano A. et al. ADEM after ChAdOx1 nCoV-19 vaccine: a case report. Mult. Scler. 2022;28(7):1151–1154. doi: 10.1177/13524585211040222Chen S., Fan X.R., He S. et al. Watch out for neuromyelitis optica spectrum disorder after inactivated virus vaccination for COVID-19. Neurol. Sci. 2021;42(9):3537–3539. doi: 10.1007/s10072-021-05427-4Cao L., Ren L. Acute disseminated encephalomyelitis after severe acute respiratory syndrome coronavirus 2 vaccination: a case report. Acta Neurol. Belg. 2022;122(3):793–795. doi: 10.1007/s13760-021-01608-2Ozgen Kenangil G., Ari B.C., Guler C., Demir M.K. Acute disseminated encephalomyelitis-like presentation after an inactivated coronavirus vaccine. Acta Neurol. Belg. 2021;121(4):1089–1091. doi: 10.1007/s13760-021-01699-xFujikawa P., Shah F.A., Braford M. et al. Neuromyelitis optica in a healthy female after Severe Acute Respiratory Syndrome Coronavirus 2 mRNA-1273 vaccine. Cureus. 2021;13(9):e17961. doi: 10.7759/cureus.17961Shimizu M., Ogaki K., Nakamura R. et al. An 88-year-old woman with acute disseminated encephalomyelitis following messenger ribonucleic acid-based COVID-19 vaccination. eNeurologicalSci. 2021;25:100381. doi: 10.1016/j.ensci.2021.100381Kania K., Ambrosius W., Tokarz Kupczyk E., Kozubski W. Acute disseminated encephalomyelitis in a patient vaccinated against SARS-CoV-2. Ann. Clin. Transl. Neurol. 2021;8(10):2000–2003. doi: 10.1002/acn3.51447Patone M., Handunnetthi L., Saatci D. et al. Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection. Nat. Med. 2021;27(12):2144–2153. doi: 10.1038/s41591-021-01556-7